Fracture Prevention

Secondary fracture prevention has become an integral component of the fracture care pathway in many orthopedic units worldwide (1). The goals of fracture prevention programs are to mitigate the risk of future fractures (2) with the attendant of high mortality (3), loss of independence and reduced quality of life (4) and other socioeconomic-related consequences (5).

The Fracture Prevention Program at St. Michael’s Hospital, the first in Canada, is a co-ordinator-based multidisciplinary quality assurance program which facilitates the identification, education, bone health assessment and appropriate treatment of people who have sustained a fragility (low trauma) fracture in order to prevent future fractures.

Core Researchers

Osteoporosis Exemplary Care Program Coordinator

  • Victoria Elliot-Gibson, MS


Phone:  416-864-6060  Ext. 77032



Featured Study

Osteoporosis Screening for patients who had a fragility fracture in Ontario

The co-ordinator identifies men, aged 50 years and older, and women, aged 40 years and older, who have sustained a low-trauma fracture of the distal radius (wrist), proximal humerus (shoulder), proximal femur (hip) and vertebrae (spine) in both the outpatient Fracture Clinic and inpatients on the orthopedic unit. Fracture Clinic patients are:

  • educated on fracture prevention and nutrition
  • referred for a bone mineral density test, if indicated

referred back to their family physician or to a specialist at St. Michael’s Hospital for a complete bone health assessment and implementation of prescription treatment to lower their future fracture risk, if indicated

Inpatients are assessed by either Geriatrics or Rheumatology for a bone health assessment, and if follow-up is required, the co-ordinator arranges a bone-mineral density test and an outpatient appointment at the Post Fracture Osteoporosis Clinic.

Quality Assurance

In addition to the clinical program, there is a quality assurance/improvement component of the program. Patients are provided with a quality assurance questionnaire, which is voluntary to complete, that asks about fracture history, family history of fracture, risk factors for fracture, prior bone health testing and treatment, as well as perceptions and knowledge of fracture and osteoporosis. Patients agreeing to follow up are also provided with a six-month, follow-up questionnaire that asks about bone health testing and treatment done within the six months, as well as knowledge and perception of fracture and osteoporosis. This information allows us to continually review the success of our program and to make necessary program modifications.

Our Sponsors

This program has received funding from:

  • Clifford Martin
  • Helen McCrea Peacock Foundation
  • Warner Chilcott
  • Merck Frosst Canada Inc.
  • Amgen Canada
  • Novartis Canada Ltd.


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